(Fig 2-B.08) Abnormal orientation or bowing of the ACL

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1️⃣ MRI Imaging Findings for ACL Tears:

• Positive Predictive Value: A discontinuous anterior cruciate ligament (ACL) or an abnormal horizontal orientation of the ACL is indicative of a 100% positive predictive value for an ACL tear.

 

2️⃣ Horizontal orientation of ACL:

• An angle greater than 15º between the roof of the intercondylar notch and the ACL suggests a complete tear.
  
• An angle less than 45º between the distal ACL and the tibia, indicating a horizontal orientation of ACL fibers, is also highly accurate for diagnosing complete ACL tears.

 

3️⃣ Blumensaat Angle:

• The Blumensaat angle is created by the intersection of the Blumensaat line and a line along the margin of the ACL, including its distal portion.
  
• Negative (Normal) Blumensaat Angle: The apex of the angle is directed superiorly.
• Positive (Abnormal) Blumensaat Angle: The apex of the angle is directed inferiorly.

 

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